Head Impact Exposure in American High School Football and Ice Hockey: A Longitudinal Prospective Cohort Study

Abstract

<h3>Research Objectives</h3> To prospectively investigate the relationship between head impact (HI) exposure, neuropsychological performance, and reported symptoms in youth football and ice hockey players in the United States. We hypothesized that exposure to greater linear and rotational forces would be associated with neuropsychological inefficiency and increased symptoms. <h3>Design</h3> Longitudinal prospective cohort over the course of one year. <h3>Setting</h3> General community. <h3>Participants</h3> Volunteer sample comprised of male student-athletes with current or planned participation in American football or ice hockey who were within 90 days of starting 10th or 11th grades (N=34). Those who had significant developmental, academic, or neurologic history or did not complete one year follow up (n=9) were excluded. <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> Linear and rotational acceleration/deceleration forces were measured via helmet sensors (football) and mouth guards (ice hockey). Participant background (past medical history of specific learning disorder, attention disorder, mood or anxiety disorder, or headache/migraine), neuropsychological testing (ImPACT, paper/pencil measures), concussion history, and symptom report (PCSS) were gathered during preseason (PS) and at one year follow up (FU). Neuropsychological inefficiency (NPI, Beauchamp, 2015) at FU and change in total reported symptoms were calculated. <h3>Results</h3> Participant background and previous concussion were associated with increased odds of NPI (all odds ratios=5.57-15.76, all ps=0.24-0.27) and symptom increase at FU (all OR=1.56-5.57, all p=0.26-0.85), albeit none were statistically significant. No significant associations were observed for HI exposure variables. <h3>Conclusions</h3> In this pilot study, we did not observe statistically significant associations between HI exposure and neuropsychological inefficiency or increased symptoms at one year follow up. Larger studies with a broader participant pool (e.g., additional contact sports, females) and longer-term follow-up are warranted to corroborate these findings. If the present findings are substantiated, results would support safe participation in contact sports. <h3>Author(s) Disclosures</h3> None.